Lecture 4: Complex Pharmaceutical Care Planning

Question 1

What is a pharmaceutical care plan?

Answer 1

• Concise document written by pharmacists which detail a patients medical history
• Often used by hospital pharmacists when completing med rec for a new patient

Question 2

What types of issues does a pharmaceutical care plan help to identify?

Answer 2

• Missing meds
• Wrong dose/ drug
• Adverse drug reactions
• Drug interactions
• Missed Doses

Question 3

What are the steps involved in a medicines reconciliation?

Answer 3

1. Take a drug history of the patient: Ask patient, GP records, family carer, summary care record etc
2. Compare against drug chart/ what patient needs. Legal record of drugs administered. Prescription
3. Make note of errors or non matches

Question 4

What are the benefits of a PCP?

Answer 4

• Create a single source document
• Improve patient safety
• Improve prescribing practice
• Reduce risk of over/under dosing. errors, adverse drug reactions
• Improve patient satisfication

Question 5

What are some PCP issues that are urgent and need resolving quickly

Answer 5

• Any missing meds/ over/under dosed
• Drugs that need therapeutic drug monitoring: antibiotics, antiepileptics
• Drugs that have a narrow therapeutic index: Lithium, Warfarin, Digoxin
• Methadone: if doses are missed then requires re titration. Used in opioid withdrawal
• Parkinsons disease meds